CO885-(6-7) — Page 692

128

will

PUBLIC RECORD OFFICE

Reference :-

TLC.O.885

mmmmíl

7

PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-

COPYRIGHT PHOTOGRAPH-NOT TO

28

times of joining, courses of teaching, &c., are somewhat more elastic than they are at Netley.

The proposed School of Tropical Medicine will be available as a training ground for doctors for all the tropical Colonies, but at the present time the most pressing case is that of Africa.

(1) It is suggested that a single Medical Service shall be created for the four West African Colonies, the Niger Coast Protectorate, the Niger Territories (in the event of their being hereafter taken over by the Government), British East Africa, and British Central Africa, and that

(2) All the members of this Service shall in future be trained at the Seamen's Hospital.

Such an arrangement offers considerable advantages.

Dr. Manson is the Medical Adviser of the Foreign Office as well as of the Colonial Office, and it will be as beneficial for the Medical Officers of the Protectorates as for those of the West African Colonies to be trained at the Seamen's Hospital.

In a large service, again, such as will thus be constituted, it may be assumed that vacancies will occur at frequent and fairly regular intervals. It will therefore be pos- sible, taking an average, to train a certain number of young doctors in advance of the Thus vacancies which may be counted upon by or shortly after the end of their course. trained doctors will be provided at short notice, a matter of great importance in the West and East African Possessions, where emergencies are constantly occurring.

Lastly, while the conditions of the various African Colonies and Protectorates men- tioned above are sufficiently uniform to justify a single service, that is to say, a service which will be treated as one for purposes of pay, pension, and promotion, they are suffi- ciently varied to offer prospects of change. Thus Medical Officers who are unfitted for further service in West Africa, will have a chance of being transferred to East or Central Africa, where the climate is on the whole healthier, while officers who have become acclimatized on the East Coast will be less likely to break down if sent on promotion to the West Coast than if sent out straight from this country.

Lord Salisbury has expressed his concurrence in principle in these proposals, but has pointed out that, as all the Protectorates administered by the Foreign Office, with the exception of the Niger Coast Protectorate, receive grants-in-aid from Parliamen- tary Funds, it will be necessary to obtain the assent of the Lords Commissioners of the Treasury to the expenditure likely to be involved. Accordingly, the next point to notice is the probable cost of the proposals.

The Seamen's Hospital have submitted a carefully considered scheme, from which it appears that arrangements can be made for the reception of on an average 30 qualified doctors, who have either been or are about to be appointed to the Colonial Service, on the following terms:-

(1) The Government to contribute a lump sum of £3,550 for the purpose of pro- viling a laboratory, pathological room, sleeping accommodation, &c.

(2) Resident students to be instructed, lodged, and boarded for an inclusive fee of £4 4s. per week.

week.

(3) The fee for non-resident students to be £2 12s. 6d. per With regard to (2) and (3), Dr. Manson is confident that, after a two months' course of instruction at the Seamen's Hospital, newly-appointed candidates may be safely allowed to take up their duties in the Colonies. The cost of training each Medical Officer will therefore not exceed £34 to £38.. It will be matter for further consideration whether the students shall pay this charge in whole or part or whether it shall be borne by the Colony or Dependency to which each particular man is assigned. The latter alter- native will probably be found necessary, as to impose such a charge upon the individual students would be likely to add to the difficulty, already sufficiently great, of obtaining In that case, so far as the suitable candidates for employment in dangerous climates. Colonies administered by this Office are concerned, the cost will be borne by the Colony to which the officer is sent, and Mr. Chamberlain presumes that the Treasury will not 'object to the same course being followed in the case of the Protectorates administered by the Foreign Office which receive grants-in-aid from Imperial Funds.

The initial contribution of £3,550 must be defrayed by the Colonies and Protector- ates concerned with the assistance of the Home Government, and as the scheme is

29

mainly intended for the benefit of Africa, so upon Africa the bulk of the expense fall.

The Crown Colonies outside Africa take comparatively few Medical Officers from this country, and some of them, such as Ceylon, Malta, and Mauritius, are practically self-supplying It will therefore be hardly fair to ask these Colonies to make any large initial contribution towards the present scheme.

But, although the new system cannot be so thoroughly applied in their case as in the case of the African Colonies and Protectorates, Mr. Chamberlain proposes to intro- duce it as far as possible in their case by giving the preference, whenever he is asked to select candidates, to those men who have been trained at the Seamen's Hospital, by pointing out the benefits of the scheme to the Colonies concerned, and urging them to avail themselves of it as far as possible (e.g., by having their Medical Officers attached for instruction if, and when, they come on leave to this country), and by inviting initial contributions to the capital sum already mentioned.

With regard to the Colonies and Protectorates in East and West Africa, the resources of Sierra Leone, the Gold Coast, and Lagos are at present strained to the utmost in maintaining order in their territory or preserving it against foreign encroach- ments; the Protectorates in East Africa are already in receipt of subsidies from the Imperial Government, and the remaining possessions are not at present in a position to afford much assistance. It is proposed to ask these Colonies to contribute to the best of their ability, but Mr. Chamberlain considers that the Imperial Government ought also to make a considerable contribution, not only on behalf of the State-aided Protec- torates, but also on account of the West African Frontier Force, which is being paid from Imperial Funds. The Imperial Government is also interested on other grounds in the success of this scheme. It is true that when Imperial troops are employed on garrison duty or in expeditions (and the following remarks apply also to naval expedi- tions, such as those which have been undertaken in recent times on the Gambia, in the Niger Coast Protectorate, and in other places) in Africa, they are generally accom- panied by Imperial Medical Officers, but cases must and do occur where, on account either of casualties among the Imperial doctors or of unforeseen emergencies, such as an outbreak of an epidemic, &c., it would be of the greatest service to the Home Govern- ment to be able to obtain assistance from a well trained Colonial Medical Department.. The same argument also applies, and will apply with increasing force, to the Crown Colonies outside Africa, where Imperial Troops are employed.

In these circumstances, and bearing in mind that the Imperial Government is ulti- mately responsible for the Crown Colonies and Protectorates of the Empire, and there- fore is strongly interested in any measures for maintaining the health and efficiency of the administrative staff, it is hoped that the Lords of the Treasury will consent to sanction a contribution from Imperial funds of a moiety of the initial cost, say, from £1,500 to £2,000, leaving the balance to be divided among the Crown Colonies.

Mr. Chamberlain considers that the comparatively small expenditure entailed by the foregoing proposals is fully justified, when the many benefits which are likely to be derived from it both by the Colonial and Imperial Governments are taken into con- sideration, and it further appears to him that the time is approaching when the matter should be carried still further. He is informed by Dr. Manson that, in consequence of recent investigations into the origin of malaria, discoveries have been made which leave little doubt that, with facilities for research on a larger scale and over a more extended area, the genesis of malaria will be traced and means found to mitigate its effects. When therefore, the more pressing question of the instruction of Colonial Medical Officers at the Seamen's Hospital has been satisfactorily disposed of, he proposes to ascertain from the Royal Society whether they consider that the scientific investigation of malaria has reached a stage at which they would be prepared to make a grant-in-aid, and, if this is so, to intimate that he will be prepared to ask the Colonies to supplement such grant by contributions from their funds. This is a matter in which the Imperial and Indian Governments as well are deeply interested, and he trusts that he may be enabled to convey an assurance at the same time that those Governments will make a moderate con- tribution towards the cost of such a scheme. He will not, however, press this point further at present.

June 1.

H. J. R.

}